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Vaccine Reactions - When should pups be vaccinated?
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Article copyright to: Karen Clark, Versailles Kennels, UK

Vaccine Reactions - When should Pups be Vaccinated, Conflict and Maternal Antibodies

The Facts:


As part of my PhD I am studying why both animals and humans react to some vaccines given to protect their future health. They are factually a preventative measure , a just in case either we or they come into contact with the disease they are designed and modified to protect against. So, why then do let’s take animals firstly react in some cases adversely. Albeit rare given the amount of vaccines given annually to domesticated small animals. I choose these as I have exceptional knowledge of these in two areas, one lifetime ownership and secondly treatment of said small animals both my own and those I rescue or come into contact with through their owners. Let me make this clear I am NOT a veterinarian but I have worked with some and also chat regularly with many in varied fields to ensure my own knowledge is up to date and more specifically science based not merely owner based, this can and does on occasion cause conflict. 

We have mentioned vaccines are a preventative measure for future health and I don’t believe any sane person would argue that point, however some are known as core vaccines both in medicine for humans and also veterinary medicine. Others are elective like holiday vaccines for us, Lepto and many others for small animals. The reason I am writing this is as I say for use within my studies and also to help owners realise facts rather than googling what is in the main owner biased views across the internet which causes conflict and can be dangerous to your pets. Many owners are unaware of what is a core vaccine , simply it is a vaccine designated as CORE is highly recommended for administration to all dogs and all cats. Vaccines placed in this category are designed to protect dogs from highly virulent, life-threatening infections (especially virus infections) and zoonotic disease (rabies). A vaccine designated as NON-CORE is considered optional and generally should only be administered to those dogs/cats with a known or suspected risk for exposure.This INCLUDES Lepto. 


There are types of vaccines available and here they are. Vaccines available for use in dogs and cats can be divided into 3 types based on current manufacturing technology: Inactivated (killed), Attenuated (modified live); and Recombinant. Inactivated Vaccines contain killed antigens (bacteria or virus). As such they are “noninfectious” and cannot replicate or revert to virulence post-injection. Because of that, they are often classified as “very safe” vaccines. However, inactivated vaccines tend to contain extraneous proteins (excipient), many also contain adjuvant, which can increase risk for development of acute vaccine reactions (facial edema, shock) and have been attributed to causing delayed onset adverse reactions, eg, “injection-site sarcoma” in cats. In addition, inactivated vaccines tend to have the shortest durations of immunity (typically 1-year). Veterinarians should be alert to the package label, which must classify the immunizing antigen as “killed”. When an alternative choice is available, it is generally preferable to use either an attenuated or recombinant product…the potential advantages being longer duration of immunity and reduced reaction risk. Modified-Live (attenuated, or MLV) Vaccines contain either bacteria or virus capable of replicating in the patient following inoculation, hence they are also called “infectious” vaccines. Because vaccine virus/bacteria have been attenuated, the risk of causing clinical signs/illness post-inoculation is significantly low today. Attenuated vaccines induce a sustained protective immune response lasting, typically, for several years following initial immunization. Unless combined with a killed antigen, attenuated vaccines do not contain adjuvant. The safety of MLV vaccines used today is excellent. For this reason, MLV vaccines are recommended over killed vaccines when the choice is available. Technically speaking, there is a slight risk that, in some patients, replicating virus/bacteria in the vaccine will cause clinical signs consistent with the disease the vaccine intends to prevent following inoculation. Occasional reports of illness have been linked to IN Bordetella bronchiseptica vaccines, MLV Distemper and Parvovirus (dog and cat) vaccines. True reversion of attenuated vaccine virus to a virulent virus is not likely today. 

There is an issue currently with the Lepto 4 vaccine , reactions vary but it is being seen now that some not all dogs are showing a reaction. These range from allergies that did not exist previously not even with the parental lines used or the siblings from a litter to death. Sadly yes some dogs have died after being given this vaccine. The BVA have issued a statement which is what can be best described as a non-committal statement , after all they do not want their members being sued for wrongful deaths of beloved pets across the UK. The very same type of non-committal statement was issued by the BMA during the Thalidomide vaccine reactions in the 1960’s and 70’s. We have come to expect this from these organisations and can look to the shoddy statements that have since been proven factually wrong like the Hillsboro issues etc, some may argue what has that got to do with vaccines, well in one way nothing, but in many ways lots as it is the reactions we receive that then assume the lay person is not understanding facts. When in reality it is nothing more than a blame saving exercise issued by large organisations that are effectively unions for groups of person that practice within that field. 

So lets begin with facts:

No veterinarian wants to harm an animal. It’s more comfortable to blame the problem on coincidence, genetic defects, other medications, etc. 

Vets don’t tie the reaction to the vaccine … unless it happens almost immediately. Here is what the American Veterinary Medical Association (AVMA) and the BVA tells dog or cat owners to watch for after vaccination. 

Note that most reactions listed are only those happening almost immediately: 

Discomfort and swelling at the vaccination site 
* Mild fever 
* Decreased appetite and activity 
* Persistent vomiting or diarrhea 
* Hives 
* Swelling of the muzzle. face, neck or eyes 
* Severe coughing or difficulty breathing 
* Collapse 
* Respiratory distress occurring 2-5 days after your pet receives an intranasal Bordetella [kennel cough vaccine] 

Veterinarians practicing in the UK, Europe, the US, and Canada, appear to have incorporated at least some of the recommendations put forward in the latest Vaccination Guidelines offered by the World Small Animal Veterinary Association (2010) 2 , Vaccine Guidelines Group), the American Animal Hospital Association Canine Vaccination Guidelines (2011)3 and the American Association of Feline Practitioners Feline Vaccination Guidelines (2013)4 . However, as the list of vaccines licensed for use in veterinary medicine continues to grow and vaccine technologies change, veterinarians continue to be challenged with new, sometimes complex, even conflicting, information regarding the selection and use of companion animal vaccines. FACT: Administering several vaccine to dogs at the same appointment may pose increased risk for an acute-onset reaction (hypersensitivity)…this is especially true for small breed ( ≤10 kg adult body weight). Today, it is recommended that, especially in small breed dogs, that veterinarians consider delaying administration of NON-core vaccine until 2 to 4 weeks after completion of the CORE vaccines. Then, administration of any NON-core vaccine should be limited to those patients having a reasonable risk of exposure to the pathogen.
 

REF: Moore GE, Guptill LF, Ward MP, et al. Adverse events diagnosed within three days of vaccine administration in dogs. J Am Vet Med Assoc. 227:1102–1108, 2005. 

What I noticed this week was a new Vet and his comments to my statements when he asked why I didn’t want Lepto 4 Vaccine. He the added anaphylaxis and delayed reactions but did not go into them. I know the reactions mostly seen post vaccine , I have a son with Aspergers he was developmentally fine until he received MMA then he became quite poorly and withdrawn, was that coincidence, well Drs say yes, I cannot believe that at all. I also have seen and advised owners when they have called me in early hours frantically because the reactions are severe and their dogs have been placed on IV drips to save them. Some reactions are fatal this is fact albeit rare. I have also been noting with interest the reactions one dog has had post vaccine and will watch this for life of that animal, his owner is aware I do NOT want that dog to receive any other vaccines not any for 4 years. I bet his health will improve greatly. Both vaccine safety and effectiveness depend to a variable extent on how individual pets react to the immune stimulus of the vaccine, as well as to its intrinsic qualities. The latter of these-the vaccines’ intrinsic qualities-is one reason that vaccines are never entirely free of reactions, some of which may be severe, eg, anaphylactic shock. Nevertheless, the incidence of significant adverse effects such as anaphylaxis are generally quite low (1/10,000 to 10/10,000 pets vaccinated) and the risk/benefit ratio is extremely favourable. protective level of antibody. The reason: immune “memory” derived from a population of effector B cells .

Vaccine manufacturers generally test vaccines for reactions for only one year, with the exception of the 3-year rabies vaccine. Testing is expensive so they do only what is required to get approval. Post-vaccination adverse reactions can be classified into the following degrees of severity: 


* Class I - Not related to vaccine 
* Class II - Lump/swelling at vaccination site 
* Class III - Facial swelling; generalized urticaria 
* Class IV - Systemic signs; fever, vomiting, diarrhea 
* Class V - Anaphylaxis, shock, collapse, death 

The incidence of post-vaccination adverse reactions in dogs remains relatively low. According to data from our practice’s reporting system, only 16 dogs out of every 10,000 vaccinated showed any kind of adverse reaction, as detailed in Table 1. The rate of anaphylaxis was much lower, at 2/10,000 vaccinated dogs. Most recorded reactions were in reaction Classes II and III. 


National Data (2003) Banfield Reporting System

In 838,015 vaccinated doses given 1365 reactions were noted that means the reaction rate is 0.16% (16/10,000 vaccinates). 186 of those were serious anaphylaxis meaning that the rate of anaphylaxis rate is 0.02% (2/10,000 vaccinates).

If we look at relationship between breed size and reactions we see that:


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Clearly adverse reactions in small breeds versus large breeds shows a clear increase in incidence in smaller breeds This phenomenon (more reactions seen in smaller breeds) has been noted by others, and the breed and family susceptibility suggest a genetic predisposition to adverse reactions [1]. A vaccine specially developed for smaller breeds may be warranted but is highly unlikely as this costs money and simply they just don’t care enough to do this. All vaccines may be associated with several different types of reactions, but the overall incidence rate is very low.


1. AVMA Principles of vaccination. J Am Vet Med Assoc 2001;5:219. 

2. 2010 WSAVA Guidelines for the Vaccination of Dogs and Cats, available at www.wsava.org

3. 2011 AAHA Canine Vaccination Guidelines are available at www.aahanet.org

4. 2013 AAFP Feline Vaccine Guidelines are available at www.catvets.com. 

This is the universal protocol for adult vaccines.

BOOSTER Recommendations for ADULT DOGS: 

* After completing the initial series CORE vaccines (distemper+parvovirus+adenovirus-2) it is recommended to administer a single dose (combination vaccine) every 3 years or longer. 

NOTE: substantial data exists to demonstrate that dogs derive protective immunity for several years following administration of MLV Core vaccines. So then we must question why vets still insist on vaccination annually when their own guidelines suggest 3 yearly . Non-CORE vaccines: administer annually where risk of exposure is sustained yet still again some vets want to do non-core vaccines even when there is NO risk ? : Concern is over the role of adjuvant-containing vaccines (virtually all killed feline vaccines contain adjuvant) in causing fibrosarcoma. This continues to be a highly controversial issue. A few facts are worth considering: adjuvants, by their very nature, induce inflammation, typically...chronic inflammation lasting days to weeks (or longer). The cellular response associated with adjuvant-induced inflammation is still regarded by most oncologists and other academicians who work with vaccines to be responsible for the DNA injury (oxidative injury) associated with metaplasia in fibroblasts. In genetically pre-disposed cats (it appears), there is risk of neoplastic transformation of fibroblasts into fibrosarcoma (or other types of mesenchymal tumor). BE PRACTICAL...avoid adjuvanted vaccines in cats! 

REF: AAFP Feline Vaccine Guidelines-2006; available at www.catvets.com. 
REF: Martano M. et al. Feline Injection-site Sarcoma: Past, Present, and Future Perspectives. Vet. J. 2011 (188) 136-141. 
REF: Woodward KN. Origins of Injection-Site Sarcomas in Cats: The Possible Role of Chronic Inflammation- A Review. ISRN Vet. Sci. 2011. Article ID 210982 

“When are my dogs protected once vaccinated?”, is a question asked by almost every owner to the breeder , well - KILLED VACCINE-assuming no maternal antibody, 2 doses are required, 2 to 4 weeks apart, then about 7 days later (~ 21 to 24 days minimum). - MODIFIED-LIVE VACCINE-assuming no maternal antibody, about 5 to 7 days following a single dose. - RECOMBINANT VACCINE...depends on the antigen. Recombinant CDV canine distemper virus (rCDV) vaccine has been shown to immunize dogs 2 weeks earlier than MLV following a single dose…due to less interference from maternally derived antibody. Recombinant LYME and Recombiant FeLV vaccine both require 2 doses, 2 to 4 weeks apart…protection is expected within 7 days following the second dose. 

REF: Greene CE and Schultz RD. Immunoprophylaxis. Chpt 100, in CE Greene (ed): Infectious Diseases of the Dog and Cat. 3rd ed. pp. 1069-1119, 2006. 
REF: Larson, L and Schultz, RD. Effect of vaccination with rCDV vaccine immediately before exposure under shelter-like conditions. Vet Therap 7(2):113-118, 2006. 
REF; Pardo MC, Tanner P, Bauman J, et al: Immunization of puppies in the presence of maternally derived antibodies against canine distemper virus. J Comp Path. 137:S72- S75, 2007. 
REF: Compendium of Animal Rabies Prevention and Control . MMWR Recomm Rep. 2011 Nov 4;60(RR-6):1-17 

Buying rom a responsible breeder all your pups will carry maternal antibodies and be better protected, breeders should have the knowledge to advise owners for vaccines, If not they shouldn’t be breeding. Breeding is NOT a hobby it’s a responsibility to a genetic pool of live animals! 

Titer Testing- Is this good or bad, Is my pet protected? 

Antibody titers as an assessment of immunity. Specific limitations apply to titers when assessing the immune status of an individual patient. Fact: titers for CDV, CPV, and feline parvovirus (panleukopenia) correlate extremely well with protective immunity...dogs/cats that have a “positive” titer are considered immune…quite likely for many years. Fact: a “negative” antibody titer for CDV, CPV and Feline Panleukopenia GENERALLY indicates susceptibility, especially in a young animal or in an animal determined to be a “genetic non-responder” 

However, antibody (Ab) is a glycoprotein and plasma concentrations may decline over time in the absence of revaccination or exposure. Animals that were previously vaccinated may lose Ab over time; however, immunologic “memory” (B-lymphocytes) is retained for many years, especially following vaccination with attenuated viral vaccines. Exposure to virulent virus in a previously vaccinated, but antibody-negative patient, typically results in a rapid anamnestic ‘boost’ of antibody titer and a protective immune response. For other diseases, antibody titers are not good correlates of protective immunity. Feline herpesvirus-1 and feline calicivirus titers can be obtained, but are not recommended for the assessment of the individual patient’s immunity to those diseases. FeLV titers are not valid at all because of the lack of a valid test method. Leptospirosis titers are routinely performed but generally are used to define exposure/infection…not immunity. 


REF: Greene CE and Schultz RD. Immunoprohylaxis. Chpt 100, in CE Greene (ed): Infectious Diseases of the Dog and Cat. 3rd ed. pp. 1069-1119, 2006 

To determine whether or not a puppy or kitten RESPONDED TO THE INITIAL VACCINATION SERIES, a titer can be submitted 2 or more weeks following the last dose of the initial series. - To assess whether an adult animal has maintained an antibody titer (CDV, CPV, Feline parvovirus) following previous vaccination (e.g., years earlier, with no recent revaccination). - Veterinarians may elect to determine titers, rather than administer booster vaccines in patients with a history of having had a SERIOUS VACCINE REACTION-or- having been treated for and recovered from an immune-mediated disorder (e.g., hemolytic anemia or thrombocytopenia) can be tested to determine their immune status.

REF: 2011 AAHA Canine Vaccination Guidelines; available at: www.aahanet.org 

What many do not realise is that an adult dog that was appropriately immunized as a pup and received DHP boosters at 1 year. Although the licensed duration of immunity (DOI) for the core vaccine components (DHP) is three years, there is now evidence for a minimum DOI of 9 years for CDV and CPV and, in reality, a dog that is appropriately immunized as a pup probably never requires another core vaccine during its lifetime. The emerging vaccine-related concerns have focused on the necessity of "annual" vaccines of adult dogs combined with the mounting evidence that vaccines can cause serious systemic diseases. The resulting debates, ongoing scientific studies and biological manufacturers' initiatives are changing the way we recommend vaccines for both the house dog and the sporting dog breeds. Vaccine risk awareness, cost factors, antigen overload considerations, and regional variations now necessitate that the owner and veterinarian to make rational and balanced vaccine selection decisions based on risk assessment of their animals. This is why breeders that act responsibly should be sought out by pup buyers, a breeder with knowledge on animal health well being and mental fitness is far more important than the breeder with trophies for showing their dog, how many times has Crufts BIS been dead within 3 years and how many times has the winner been shown to be a mass producer of illness within its specific breed. These are the questions any buyers should be asking. This is why the UK Kennel Clubs ABS is a sham to scam buyers. 

Some systemic diseases are linked to vaccines yet you are not told this ! Unlike allergic reactions, the cause and effect of various canine vaccines with these diseases are less clear cut and the scientific basis for the relationship is often anecdotal. The following conditions in dogs has been associated with or implicated as possibly caused by various vaccinations: 
* Anosmia 
* Allergic reactions 
* Autoimmune hemolytic anemia 
* Immune mediated thrombocytopenia 
* Immune Thyroiditis (hypothyroidism) 
* Immunosupression 
* Epilepsy 
* Hypertrophic Osteodystrophy (HOD) 

The evolving trend in small animal biologicals has been to incorporate numerous antigens (polyvalent vaccines) into a single "all-in-one" dose. Recent concerns have surfaced regarding the widespread use of polyvalent vaccines because they are believed to cause a significant decrease in immune function. Note the similarity in human medicine . Possible Immunosuppression may result when the amount of antigen introduced into the dog exceeds the ability of the immune system to respond. Such a condition is termed antigen-overload. While the various study results are often conflicting, several clinical studies exploring different polyvalent vaccines have demonstrated some degree of immunosuppression associated with inoculation with polyvalent vaccines. Vaccinating puppies every 14 days using polyvalent vaccines, the pup's immune system will be challenged during the immunosuppressive period. The use of monovalent vaccines in stressed puppies and vaccinating every three weeks might be a better immunization strategy. Something each breeder or owner should discuss with their vet, I know mine will do as I ask even if delayed. My own pups are not vaccinated until they are aged about 13 weeks just as maternal antibodies are starting to lessen, this is because I am fully aware that vaccines given to pups are at best only 65% effective due to the conflict with maternal antibodies. 
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